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Strategic purchasing has the potential of increasing equity in access to quality services and ensuring financial protection through deliberate effort to purchase services with the best value for money.  This study examines the purchasing arrangements in schemes funded by the federal budget and the Formal Sector Social Health Insurance Programme (FSSHIP) within the National Health Insurance Scheme in Nigeria. Results show that steps toward strategic purchasing are advancing, particularly in the design of benefit packages, accreditation and monitoring of health maintenance organizations  and providers, and provider payment mechanisms. The authors conclude by recommending that Improving strategic purchasing in Nigeria will require a concerted effort to reduce fragmentation of health spending, significant investment in human resources, technical know-how, and actions to improve the accountability of all actors in the system.
 
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